FILE - This May 6, 2008 file photo shows a nurses station overlooking the injection booths at Insite in Vancouver, Canada. Insite is the first legally supervised injection site in North America and is located in Vancouver's Downtown Eastside. (AP Photo/The Canadian Press, Jonathan Hayward, File)— AP

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FILE - This May 6, 2008 file photo shows a nurses station overlooking the injection booths at Insite in Vancouver, Canada. Insite is the first legally supervised injection site in North America and is located in Vancouver's Downtown Eastside. (AP Photo/The Canadian Press, Jonathan Hayward, File)
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VANCOUVER, British Columbia 
Five blocks away from the venue for Vancouver's Winter Olympics opening ceremonies, four grizzled addicts huddle in the rain, injecting themselves with heroin behind a trash bin.

This is the Downtown Eastside, where life is volatile and the slightest misstep can invite brutal retaliation.

"It's a jungle," said Glen, a 49-year-old heroin addict who goes by the street name Trouble. "You want to get out of here."

As Vancouver prepares for the Olympics and the descent of the world's media, the Downtown Eastside remains a huge problem - 15 square blocks of despair, squalid rooming houses and alleys populated by thousands of addicts, the homeless, the mentally ill and the drug dealers who prey on them.

This neighborhood is the most concentrated drug and poverty ghetto in North America, with high use of heroin, cocaine and methamphetamine, according to criminologist Benedikt Fischer of Simon Fraser University. It also is the only place in North America where drug addicts can shoot heroin into their veins at an officially sanctioned injection site.

At the center of the neighborhood is a neoclassical building endowed by philanthropist Andrew Carnegie in 1903. Behind it, dealers and pimps hawk drugs and women in a filthy alley. On the building's front steps is Vancouver's largest open-air drug market, at the intersection of Main and Hastings streets, called "Pain and Wastings" by locals.

Across the street is Vancouver's biggest police station. Police Const. Lindsey Houghton said officers often find themselves in the role of social workers while continuing to target the drug trade. About 49 percent of Downtown Eastside calls are related to mental health, according to the Vancouver Police Department.

The International Olympic Committee's bid evaluation team did not see the Downtown Eastside when it assessed Vancouver's bid in 2003. When it came time to tour Vancouver venues, the IOC's bus took a wide detour around the neighborhood.

The bid evaluation team did see the scenic but treacherous highway from Vancouver to Whistler, host of alpine and sliding events. While about US$500 million has been spent on the road, the Downtown Eastside remains much the same.

As they did in 2003, welfare recipients still line up once a month to receive their welfare checks. Welfare Wednesday is known as Mardi Gras in the area, a day the recipients become what they call "two-day millionaires." Needle exchange staff work on the welfare lines.

The area gained international attention when pig farmer Robert Pickton was arrested in 2002 and charged with the deaths of 26 prostitutes and addicts from the Downtown Eastside, in what police say is Canada's worst serial murder case. He was convicted of killing and butchering six of them at his suburban farm. Some remains he fed to pigs. The rest went to a rendering plant.

Mona Wilson's head, hands and feet were found in a bucket at Pickton's farm. Her brother, Jason Fleury, called the Downtown Eastside a time bomb and accused officials of doing nothing to defuse it while spending millions on the Olympics.

"It's crazy. It's insane," said Fleury.

Prostitution rights activist Jamie Lee Hamilton said little has been done to curb violence against prostitutes since Pickton's arrest.

"There is this perception that all the violence ended when Pickton was arrested," Hamilton said. "We know it's hunting grounds down there, and we're doing nothing about it. The women, the men and the transgendered are living prey."

Due in part to rampant intravenous drug use, the area's HIV rate is the worst in the developed world, said International AIDS Society president Dr. Julio Montaner. The HIV rate qualifies the Downtown Eastside for World Health Organization epidemic status, he said.

Montaner said the combination of drug and health programs as well as housing initiatives are beginning to slow the crisis. But progress may be halted by the increasing violence of Vancouver's drug trade, as cocaine prices skyrocket in the aftermath of a Mexican crackdown on drug cartels.

Critics allege the Downtown Eastside will be sanitized during the Games under recently passed legislation that allows police to force the homeless into shelters in cold weather. That would violate bid assurances, they say.

"Nobody has a right to move those people simply to accommodate a better visual image for the Olympics," said provincial legislative housing critic Shane Simpson.

Vancouver Organizing Committee vice president of sustainability Linda Coady said the issue has nothing to do with the organizing committee, and that VANOC's interest is what goes on inside Games venues.

"Outside is the domain of the Vancouver Police Department," Coady said.

Meanwhile, the safe injection site in the Downtown Eastside is the busiest in the world, with about 500 supervised injections a day, according to Russ Maynard, supervisor of Insite, a provincial government-financed office for Downtown Eastside. Addicts shoot up at 12 booths with mirrors on the walls so that nurses on a raised platform can see them.

Maynard said by the time addicts get to the Downtown Eastside, they are totally dysfunctional. Even trying to get help is hard, he said, as pay phones are used constantly to make drug deals.

"You could get beat up for tying up a phone for five minutes," he said.

He said 90 percent of people using Insite have Hepatitis C. The national rate is less than 1 percent.

Insite has operated for six years under an exemption from Canada's health laws. The federal government's attempt to close Insite ended Jan. 15 when the British Columbia Court of Appeal ruled addicts had a constitutional right to health care. Whether the case eventually reaches the Supreme Court of Canada remains to be seen.

Above Insite is Onsite, a 12-bed operation offering detox and the start of a recovery program.

"Those who come in are stick and bone," said Onsite manager Liz Moss. "They need to rest. They need to eat."

Vancouver Mayor Gregor Robertson said the city and province have opened hundreds of shelter beds and housing units in the past year, but the provincial government needs to put more money into addiction treatment and housing.

"Every big city has these extremes now that are very uncomfortable and need to be remedied," he said.